- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.86 / $80.75 / $9,062.00
| Facility | | $28.86 | $80.75 | $9,062.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.46 / $10.41
| Professional | | $2.40 | $2.46 | $10.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.76 / $38.86 / $97.31
| Facility | | $3.76 | $38.86 | $97.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.09 / $9.09 / $12.43
| Professional | | $9.09 | $9.09 | $12.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.05 / $25.60 / $51.84
| Facility | | $16.05 | $25.60 | $51.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.70 / $11.72
| Professional | | $1.58 | $1.70 | $11.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.70 / $6.68 / $9.17
| Facility | | $2.70 | $6.68 | $9.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $3.00 / $4.00
| Professional | | $3.00 | $3.00 | $4.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $1.65 / $2.38
| Professional | | $1.65 | $1.65 | $2.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.80 / $6.60
| Professional | | $1.26 | $1.80 | $6.60 |